World Top-10 CROs and Why?

As of my last knowledge update in September 2021, the list of the top Contract Research Organizations (CROs) can vary depending on factors such as revenue, services offered, therapeutic areas of expertise, and global presence. The following list includes some of the prominent CROs based on their reputation, scale, and contributions to the clinical research industry:

IQVIA (formerly QuintilesIMS):
IQVIA is one of the largest CROs in the world, offering a wide range of services including clinical development, real-world evidence solutions, commercialization services, and consulting. They have a vast global network and expertise across various therapeutic areas.

PPD (Pharmaceutical Product Development):
PPD is known for its comprehensive clinical trial services, laboratory services, and real-world evidence solutions. They have a strong global presence and experience in managing trials of varying complexity.

Covance:
Covance, a subsidiary of LabCorp, is known for its extensive portfolio of drug development services including clinical development, central laboratory services, and market access solutions. They have experience in a broad range of therapeutic areas.

Syneos Health:
Syneos Health offers integrated solutions across clinical development, commercialization, and real-world evidence. They focus on helping clients navigate the entire drug development journey.

ICON:
ICON provides a variety of clinical research services, including consulting, clinical trial execution, laboratory services, and outcomes research. They have expertise in a wide array of therapeutic areas.

Parexel:
Parexel offers services ranging from clinical research and regulatory consulting to market access and commercialization. They are known for their global reach and innovative approach to clinical trials.

WuXi AppTec:
WuXi AppTec is a global company that provides a wide range of R&D services, including preclinical and clinical development, manufacturing, and regulatory services.

Medpace:
Medpace is known for its focused and customized approach to clinical trial management, particularly in the area of complex and specialized studies.

Celerion:
Celerion specializes in early-stage clinical research, with a focus on providing solutions for both small and large molecules.

Charles River Laboratories:
While Charles River Laboratories primarily focuses on preclinical research, they also offer a range of early-stage clinical development services.

1. Welcome World Top 10 Contract Research Organizations Sanai Mondal M.Sc Microbiology Student ID- 159/082023 10/18/2022 www.clinosol.com | follow us on social media @ clinosolresearch 1

2. Introduction Contract research organization- also called clinical research organizations(CROs) are essential to the pharma, biotech and medtech industries supporting their efforts to test, refine and market their latest drug and devices. According to Global market Insights in 2022the global CRO market was valued at US$56.5 billion and by 2028, it is expected to reach an impressive US$108 billion, with CAGR of 6.5% from 2023 to 2032. Growth is being powered by a surge in research and development expenditures and activities and a significant rise in the number of clinical trials with the need for medical advancements. The Covid-19 pandemic drove large number trials in the race to find a preventive vaccine and treatment options which meant contract research organizations need to expand their teams rapidly. In last few years, mergers and acquisitions have progressively changed the marketplace and some of the largest CROs have been strengthened through joining forces or being bought out by other companies. Some of the most notable changes in the market have included: Clintec being absorbed by IQVIA ,PRA being bought by ICON ,Thermo Fisher Scientific acquiring PPD, EQT Private Equity and Goldman Sachs Asset Management buying out Parexel . The top 10 CROs to watch in 2023 are listed below, this list is based on knowledge of the industry and no particular order but included both industry leaders by market share and revenue and who are steadily increasing their presence through strategic collaboration and innovative service offering. 10/18/2022 www.clinosol.com | follow us on social media @ clinosolresearch 2

3. An analysis of  the global CRO services market  highlighted the trend of major pharmaceutical companies improving R&D efficiencies through increased R&D spending and collaborative R&D efforts. There has been growth in the drugs and biologics market as well, opening up more opportunities for CROs to provide more modern services. Furthermore, the CRO market has been significantly influenced by mergers and acquisitions (M&A), leading to the consolidation of some of the industry’s largest players. In 2021 alone, there were 50 completed M&A deals, including Thermo Fisher Scientifics' strategic move to acquire PPD, ICON acquiring PRA Health Sciences, Triley Bidco acquiring Clinigen , and multiple acquisitions made by Charles River Laboratories. 2023 is anticipated to be an eventful year for the contract research industry as new partnerships, technology, and expansions shape its trajectory. The list of top 10 CROs featured below are poised to deliver research services outsourced by biopharma, biotechnology, and pharmaceutical companies. This compilation, based on comprehensive industry insights, encompasses both well-established industry leaders with commanding market share and revenue, as well as rising stars steadily carving their niche through strategic collaborations and pioneering service offerings. The ranking is presented in no particular order, reflecting the diverse and evolving landscape of the CRO sector. CROs Market Dynamics 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 3

4. Charles River Laboratories International, Inc Among the top and largest CROs is Charles River laboratories a full-service, non-clinical CRO based in the U.S. It began operational in 1947 and today has over 110 locations in over 20 countries. Traded on the New York Stock Exchange, it had a total revenue was US$3.5 billion in 2021. For the nine months ending September 24, 2022, revenue was US$2.9 billion an increase of 9.1% from US$2..6 billion in the first nine months of 2021. Charles RIVER Laboratories has completed acquisitions(Which contributed 1.7% to consolidated third-quarter revenue growth)to expend the CROs portfolio and broaden its geographic footprint as well as divestitures in Japan and Sweden which purportedly has the opposite effect and reduced reported revenue growth by 2.1%. The CRO’s strategy focuses on having an integrated early-stage portfolio, a comprehensive biopharmaceutical manufacturing portfolio, deep scientific expertise, a commitment to animal welfare, superior quality and client support, offering a flexible and customized environment to provide the right solutions, and being a large, global partner. Charles River Laboratories believes that the evolving large biopharma R&D business model will increasingly benefit from its products and services, integrated offerings, and expertise. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 4

5. CMIC Holdings Co. Ltd . Among the top CROs in Japan, CMIC Co., Ltd. is a CRO with global reach founded in 1985. Seven years later, it commenced business as the first CRO established in Japan. In 2002, CMIC was listed on the Japan Securities Dealers Association Quotation (JASDAQ) Market and subsequently listed on the Second Section of the Tokyo Stock Exchange in 2004. The following year, CMIC was listed on the First Section of the Tokyo Stock Exchange. CMIC offers pharmaceutical solutions, which include its CRO, contract development and manufacturing organization (CDMO), and Market Solutions businesses; and healthcare solutions which include its site support solutions and healthcare revolution businesses. The CMIC Group Network comprises 26 companies with 62 sites worldwide – in Asia, Australia, and the U.S. The CRO’s business focus areas include: Providing enhanced development support for advanced therapies such as biologics and regenerative medicine. digital applications such as decentralized clinical trials (DCTs) and real-world data (RWD) proactively take on nucleic acid medicine projects and global clinical studies (clinical trials in Asia, Japan-US bio-analysis business) business expansion in the U.S. and Asia. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 5

6. ICON Founded in Dublin, Ireland, in 1990, ICON is one of the leading CROs providing global drug and device development and commercialization services. They have a presence in Europe, the U.S., South America, the Middle East, and Africa. ICON services span the lifecycle of product development and commercialization, serving small local trials as well as large global programs. As of September 30, 2022, ICON employed approximately 41,150 employees in 113 locations in 53 countries. ICON’s year-to-date 2022 revenue (first three quarters) was US$5,779.4 million, up 60.6% on prior year adjusted revenue or 65.1% on a constant currency basis. In 2021, ICON completed the acquisition of PRA, with the combined Group retaining the name ICON. To develop the CRO’s expertise in patient recruitment, ICON established a global clinical research network Accellacare to help patients access innovative treatments and give ICON customers the option of DCTs. ICON is also focused on improving site selection through the use of leading technology to identify patients, assessment of sites based on real data, and the development of capabilities for electronic medical record (EMR) interrogation. In 2020, ICON established a new company, Oncacare Limited, which operates as a specialized oncology site network in the U.S. and EMEA regions to accelerate recruitment and retain patients for oncology trials. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 6

7. VIAL HEALTH TECHNOLOGY INC Founded in 2020,  Vial  is one of the fast-growing CROs making waves in the industry. The  Vial CRO  is powered by technology to deliver “faster, better, and more affordable clinical trial results.” Vial is on a mission to disrupt the clinical research industry with next-generation clinical trial management and tech-enabled CRO services. By mid-2022, Vial raised more than  $100 million+  in total venture funding and, in November 2022, announced that venture firm  General Catalyst has led a $67 million Series B fund  of financing for Vial. Vial CRO’s mission is to raise the clinical research industry to the next level — to be less reliant on pathways and processes which are now defunct — and to mirror the speed and progress that its sponsor partners demand of their innovations in clinical research. Despite being a young company, Vial has rapidly demonstrated its strengths in both cutting-edge technology and efficient clinical operations. Vial’s seasoned team of  ClinOps  executives from leading CROs and technology leaders from Silicon Valley create a unique tech-forward approach. From study design and meticulous planning to seamless execution and study close-out, Vial is reimagining the very nature of clinical trials and distinguishing itself by leveraging its in-house technology platform to deliver dramatically faster and more efficient trials for sponsors. The Vial technology platform replaces paper sources in trials, supports productivity-enabling workflows, and is HIPAA, GDPR, and CFR P11 compliant. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 7

8. IQVIA Founded in 1982, IQVIA is a leading global provider of advanced analytics, technology solutions, and clinical research services to the combined industries of health information technologies and clinical research. Today, IQVIA is among the top and largest CROs and has approximately 85,000 employees in operations in over 100 countries. Compared to the first nine months of 2021, IQVIA revenue for the same period in 2022 was $10,671 million, an increase of 4.2% on a reported basis and 8.1% at constant currency. One of the ways IQVIA brings value to its clients is by combining its proprietary information assets with advanced analytics, transformative technology, and domain expertise. IQVIA reports that its collection of healthcare information includes more than 1.2 billion comprehensive, longitudinal, non-identified patient records. IQVIA’s growth strategy includes: Continuously innovating by leveraging its information , advanced analytics, transformative technology and domain expertise. Expending offering to a broader healthcare market place 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 8

9. LABCORP LabCorp is a leading global life sciences company with diagnostics and drug development capabilities that allow them to provide insights and accelerate innovations in healthcare. It has over 75,000 employees and serves clients in more than 100 countries. LabCorp reported revenue of $16.1 billion in 2021. In the first nine months of 2022, revenue was $11.20 billion, a decrease of 7.1% compared to the first nine months of 2021. Revenue for the third quarter was $3.61 billion, a decrease of (11.2%) from $4.06 billion in the third quarter of 2021. The Clinical Development business grew 8.0% on a CAGR basis from Q2 2019 to Q2 2022. While the CRO industry has been characterized by increasing mergers and acquisitions (M&As), with  50 M&A deals  completed among CROs in 2021, LabCorp announced in July 2022 a planned spin-off of its Clinical Development business. The NewCo will operate as a CRO providing Phase I-IV clinical trial management, market access, and tech solutions to biopharma companies. The rationale for the  spin-off  is that LabCorp's laboratory business and clinical development business target different markets and have different capital structure requirements and equipment needs. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 9

10. PAREXEL Parexel is a global CRO providing clinical development capabilities and integrated consulting expertise, with global study locations in the US, UK, and Germany. One of the largest CROs, Parexel, supports the development of innovative new medicines to improve the health of patients. To expand access to patient populations and increase diversity in clinical trials, Parexel launched its Community Alliance Network in 2022. In collaboration with CVS Health and Javara, the novel program integrates clinical research into the community healthcare setting. In November 2021, Parexel announced the completion of its acquisition by EQT IX fund and funds managed by the Private Equity business within Goldman Sachs Asset Management for $8.5 billion, with both parties committed to supporting Parexel’s Patients-First focus, track record of clinical excellence and dedication to quality. The newly-appointed Board of Directors brings vast experience across life sciences, digital transformation, and innovation. The Parexel leadership team and our more than 18,000 colleagues around the world remain united in our Patients-First focus and mission of advancing world health, and we’re excited about this next phase of the journey,” said Jamie Macdonald, CEO of Parexel. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 10

11. PPD PPD was established as a one-person consulting firm in 1985 and has since conducted clinical trials in more than 100 countries. Today, PPD is one of the top CROs with over 30,000 employees globally and is a leading global CRO providing comprehensive, integrated drug development, laboratory, and lifecycle management services. For the nine months ending September 30, 2021, PPD revenue increased 36.1% to $4,514.6 million compared to the nine months ending September 30, 2020. Of total revenue, the Clinical Development Services share was $3,688.2 million, and Laboratory Services was  $826.4 million . In December of the same year, PPD was acquired by Thermo Fisher Scientific for $17.4 billion. PPD’s competitive strengths include providing differentiated clinical development services and comprehensive laboratory services, having a large and growing diversified customer base, and being an experienced, highly technical organization with a culture of excellence and industry-leading retention. Key elements of the PPD growth strategy include further strengthening its offerings in existing and new markets, expanding therapeutic expertise in existing and novel areas, increasing the use of its innovative site network and patient enrollment platform, capitalizing on its laboratory segment, and investing in innovation. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 11

12. SYNEOS HEALTH Formed through a merger between INC Research and in Ventiv Health,  Syneos Health  is a global biopharmaceutical solutions organization that includes a CRO and a Contract Commercial Organization (CCO). Its business model was designed to accelerate customer success by strategically blending clinical development, medical affairs, and commercial capabilities. Syneos Health has a team of over 29,000 supporting operations in more than 110 countries. For the first nine months of 2022,  revenue was $4,033.2 million , an increase of 5.0% on a reported basis and 7.2% on a constant currency basis for the same period in 2021. Corresponding figures for the Clinical Solutions segment revenue was $3,047.3 million, increasing 2.5% on a reported basis and 4.8% on a constant currency basis. In October 2022, Syneos Health announced its  expanded partnership with Datavant  to develop advanced analytics and AI-driven technologies to increase the efficiency of clinical trials, and improve the experience for patients, sites, and biopharma customers. The collaboration with Datavant also seeks to further empower health economics and outcomes research (HEOR), medical affairs, market access, and commercial analytics for clients. Emphasis is placed on evidence continuity across the product lifecycle – including late-phase studies, RWD sources for clinical development, HEOR, and commercial analytics – towards creating an integrated evidence-generation plan. 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 12

13. Wuxi APP TECH Wuxi PharmaTech was founded in China in 2000, and upon acquiring U.S.-based AppTec Laboratory Services in 2008, Wuxi AppTec was formed. Today, it is a global company with 45,000 employees and operations in Asia, Europe, and North America, providing R&D and manufacturing services to global pharmaceutical, biotech, and medical device industries. These services include CRDMO (Contract Research, Development, and Manufacturing Organization), biology discovery, preclinical testing and clinical research services, and cell and gene therapies CTDMO (Contract Testing, Development, and Manufacturing Organization). Wuxi AppTec’s open-access platform connects more than 5,900 customers from over 30 countries to realize its vision: “Every drug can be made, and every disease can be treated . 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 13

14. Thank You! www.clinosol.com (India | Canada) 9121151622/623/624 [email protected] 10/18/2022 www.clinosol.com | follow us on social media @clinosolresearch 14